First posted on EP Lab Digest on 12/4/2012, reposted with permission of the author

Kevin R. Campbell, MD, FACC

Social media is the future of medicine. Patients, providers, pharma and industryare becoming increasingly connected. mHealth (mobile health) is the practice of medicine using technology such as mobile phones, tablet computers and other electronic devices to improve outcomes. As we reflect on 2012 and the changes that have occurred in healthcare, I am astounded by the increasingly significant roles that social media and mHealth are playing in medicine today. As recently as two years ago, small groups of mHealth pioneers were just beginning to consider the use of social media in medicine. The idea of e-patients (Internet or tech-savvy patients) emerged.

Dr. Tom Ferguson, who authored much of the initial work on online patient advocacy, defined the e-patient as “equipped, enabled, empowered, and engaged” in their health and health-related decisions. Recent surveys have shown that the number of adults using tablet computers for health-related activities has doubled from 15 million to 29 million in 2012. The Internet has become a primary source of information for many patients. Cyberspace is where our patients are today and where we, as leaders in healthcare innovation, need to be now.

So Where Are We Now?

Looking back on 2012, several innovations in social media and healthcare have developed. Patients are more engaged than ever. Online patient communities have emerged and flourished. Even as big business, major corporations and even the ever-cautious CEOs of Fortune 500 companies slowly start to develop social media personalities, healthcare providers continue to lag behind. The tools for social media interaction continue to develop and improve each day. Medical applications for social media continue to emerge, and I believe there is a great potential patient benefit. These are important points to consider at year’s end:

#1. Active engagement of e-patients. The e-patient is now an important consumer of healthcare. These patients are technologically savvy and well informed. Often the e-patient gathers information on the Internet and is well prepared for office visits. E-patients are engaged and actively participate in their own healthcare. As healthcare providers, we must not miss this opportunity to educate and market. The e-patient can be a wonderful source of referrals via electronic recommendations.

#2. Social media for providers. As healthcare providers, we remain relatively unengaged in social media. A small minority of physicians has continued to engage in social media, utilizing outlets such as Twitter, Facebook, blogging and YouTube. The interaction that I have had this year with my medical colleagues from around the world via social media has been a great learning experience for me. As a profession, physicians are still trying to figure out the best way to leverage social media in our practice; working together with other social media pioneers has allowed me to refine my online presence and improve my skills at blogging and tweeting. For example, electrophysiologist Dr. Wes Fisher has unknowingly served as a social media mentor for me over the last year. I first met Dr. Fisher via Twitter, and then had the pleasure to meet and work with him at Heart Rhythm this year. He has a longstanding, prolific blog that is a great example of how to do things the “right way.”

#3. Prescription apps. In the last year, much has been written about the use of “medical apps.” An article this year in The New York Times actually suggested that as more medical apps are developed, physicians may in fact begin to prescribe apps for their patients. Apps may facilitate tracking of medications, blood pressure readings, blood sugars and other relevant medical data. The federal government has created “contests” or challenges for developers in order to stimulate the design and implementation of healthcare apps in cardiovascular disease. Ultimately, the use of apps will help to further engage patients and improve care. There is much more to come in this area as we look to 2013.

#4. Online communities for support and dissemination of information. As the e-patient population continues to grow, more and more healthcare consumers have begun to look to the Internet for information and support. Disease-specific online communities have been developed by pioneering patients. These communities are very active and work to advocate for patient rights as well as help patients understand their disease more fully. By bonding together, patients are able to share information about the best treatments, facilities and providers. Moreover, these communities have become incredibly effective support groups. Interacting with online patient communities via Twitter and other social media outlets has a huge upside for the engaged physician. Online communities will be the way physicians are evaluated and recommended in the future. Twitter chat is the new “word of mouth.”

#5. Mobile devices. The majority of Americans now possess a mobile device capable of interacting with the Internet. These devices are fast, powerful and capable of performing multiple tasks at one time. Research by Nielson has shown that 50.4% of Americans have a smartphone, and that smartphone use is becoming more consistent throughout the age groups. No longer is the BlackBerry, iPhone and Android the toys of youth; seniors use them as well. Much has been done to develop ways to use mobile devices to monitor vital signs, electrocardiograms and other biologic statistics in real time. Some implantable cardiac device companies offer cell phones for remote monitoring of devices. The future of mHealth is clearly with the expanded use of mobile devices.

#6. Regulating the medical presence in cyberspace. As more and more medical applications are created and distributed to patients for patient care activities, there is an increasing concern among lawmakers that harm may come to patients unless there is government oversight. Rep. Mike Honda (D-Calif) has introduced the idea of a new FDA office of mobile health to help monitor and regulate health-related apps. In July, the FDA Safety and Innovation Act established a commission to develop a strategy for regulating mobile health apps. As with most government agencies, I do not expect quick progress in this arena.

Predictions for 2013 and Beyond

As a profession, medicine continues to lag behind other major industries in the adoption of social media. However, change is coming. We must embrace this change and begin to lead. We must help to define the course of the way patients and physicians will interact online today and in the future. Patients, even the elderly, are becoming more tech savvy. The e-patient is going to be the norm, and we must learn to be comfortable and accessible in cyberspace. The new classroom will be online communities, Twitter chats and blogs. Our role as physicians is rapidly changing. As always in medicine, we must evolve quickly to meet the needs of our patients and improve care. I have identified four key areas in which we must strive to build a greater medical presence in the next year:

#2: Online communities should be embraced and developed as well as prescribed. There is an enormous opportunity for these communities to be integrated with providers and healthcare systems.

#3: Discussions and seminars online (through the use of YouTube, podcasts and Twitter chats) to bring patients together with each other and to engage with healthcare providers.

#4: Social media education of healthcare providers. We must recruit new “players” and continue to shape the way physicians effectively utilize social media.

Although great strides have been made in using social media to improve patient care and outcomes, there is much left to do. We have a long way to go in 2013. A recent survey published on FierceHealthIT indicated that hospital systems and providers are only using social media in healthcare in very basic ways. Simply put, we are only scratching the surface of great potential. We must go beyond just using social media to listen to consumers and to market. We must evolve our social media utilization into actively engaging patients, disseminating information, connecting patients and providers, and more quickly responding to the rapidly changing needs of the healthcare consumer. The year 2012 has resulted in significant progress, and 2013 holds much promise. Our patients are out there, in cyberspace, waiting for us to join the party. The time is now to jump in with both feet.

Kevin R. Campbell, MD, FACC is with Wake Heart and Vascular (WHV) in Raleigh, North Carolina. He is also Assistant Professor at UNC Department of Medicine, Division of Cardiology, and Director of Electrophysiology at Johnston Health. In addition, Dr. Campbell is President of K-Roc Consulting, LLC. Dr Campbell has become a leader in the use of social media in medicine and regularly appears on radio and television.